Sparing Lymph Vessels In Laparoscopic Ligation Of Spermatic Veins

Objective:To investigate the feasibility of sparing lymph vessels in laparoscopic ligation of spermatic veins in clinic.Method:From January 2007 to November 2008,157 patients diagnosed varicocele were enrolled in the study.All cases were randomized into three groups:ligation of spermatic vessels group(group A),testicular artery sparing group(group B),testicular artery and lymph vessels sparing group(group C).Semen was examed before operation as well as after operation.The therapeutic effects after three different kinds of operation were evaluated by improvement of semen quality and complications related to operation.Results:①The quality of semen in all groups was improved after operation compared with that of before operation(P＜0.01).A significant improvement of semen quality was found in group C when compared with group A(P＜0.01).The quality of semen postoperatively was better in group B than in group A(P＜0.01,P＜0.01,P＜0.05). However,no statistical difference was found between group C and group B(P＞0.05).②The complications after operation:The rate of hydrocele in group C was lowest(0%), obviously lower than group A(29.51%,P＜0.05) and group B(27.08%,P＜0.05). Although,the rate of hydrocele in group B was slightly lower than group A,no statistical difference could be found(P＞0.05).The rates of testicular atrophy in group C(2.08%) and group B(2.08%) were lower than group A(18.03%)(P＜0.05,P＜0.05).When the recurrence rate were evaluated,groupA(1.64%),group B(2.08%) and group C(4.17%) showed similar results(P＞0.05).Conclusion:The rate of hydrocele can be reduced by sparing lymph vessels ligation of permatic veins.The quality of semen can be significantly improved by sparing lymph vessels in laparoscopic varicocele ligation.Furthermore,although no statistical difference of sperm quality is found between lymph sparing group and testicular artery sparing group,it is seemed that improvement of semen in lymph sparing group is better. Preservation of testicular artery can improve the semen quality and reduce the rate of testicular atrophy after operation.